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Docs Issue Guidelines for Drivers With Dementia
Date:4/12/2010

Memory test, input from family best gauge for who's no longer safe on the road

MONDAY, April 12 (HealthDay News) -- Scores on a dementia test and input from family members are the most useful tools in determining who is no longer capable of driving when Alzheimer's or other dementia sets in, according to new guidelines from the American Academy of Neurology.

In fact, family members' assessments are usually more accurate than the patient's own opinion of his or her driving abilities in making these decisions, the research shows.

To develop the guidelines, researchers analyzed the results of 422 studies of Alzheimer's disease or other forms of dementia and driving, and rated each based on the quality of the study and the strength of the findings.

Among the strongest predictors of gauging who would fail a behind-the-wheel driving test: scoring a "1" or higher on the Clinical Dementia Rating, a test used by doctors to assess memory, judgment and the ability to function independently at work, home and in social life. A score of "0" is no impairment; 0.5 indicates very mild dementia; 1 is mild dementia, while scores of 2 and 3 are moderate to severe dementia.

The opinions of family members and caregivers are also helpful, said lead guideline author Dr. Donald Iverson, a neurologist with the Humboldt Neurological Medical Group in Eureka, Calif. In contrast, the patient's own assessment of his or her skills isn't really reliable.

One study found that caregivers who rated a patient's driving as "marginal" or "unsafe" were often right, while another found that 94 percent of people with Alzheimer's rated themselves as safe drivers, though only 41 percent passed a driving test.

Determining who is still safe to drive can be difficult, Iverson said. Recent research has found that as many as 76 percent of people with mild dementia can still pass behind-the-wheel driving tests, while other research
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